What is Baby Bottle Tooth Decay?
It is sometimes observed in babies that brown spots occur on their teeth as soon as they erupt, or that these teeth break and fall out. In fact, these spots are dental caries, and the teeth break due to decay. The reason for the formation of caries at such an early age is the decay called ‘baby bottle tooth decay’. Breast milk or cow’s milk, which is the most important food in infant nutrition, naturally contains sugar. If a baby nurses from the breast or bottle before going to bed at night or during sleep, the milk accumulates in the mouth, creating a favorable environment for microbes to decay the teeth. For this reason, special attention should be paid to cleaning the teeth, especially after nighttime feeding.
Besides the bottle, giving pacifiers dipped in sweeteners such as honey, molasses, and jam is another cause of baby bottle tooth decay. In addition, carbohydrate-sugary foods given to the baby after the teeth have erupted also cause dental caries. It is necessary to direct the child to foods with high nutritional value that help with tooth cleaning, such as apples and carrots, instead of such foods.
Early diagnosis in baby bottle tooth decay is very important to prevent the problem from growing. Families usually do not realize that the teeth are decaying in the early stages of baby bottle tooth decay. This is because a slight whitening is observed at the gum line of the teeth in the first stage of baby bottle tooth decay. The time when families realize that the teeth are decaying is usually when brown-black discolorations occur, by which time it is too late and the teeth have decayed. The treatment to be done after this stage is filling or tooth extraction.
If teeth with baby bottle tooth decay are not treated, they become painful, inflamed, and cause the baby to become restless and the feeding pattern to be disrupted. Inflammation affects the permanent teeth that will come from underneath, causing them to have deformed shapes. If these teeth have to be extracted, speech problems may also arise in the child.
What needs to be done to prevent baby bottle tooth decay?
Since the treatment of caries occurring in babies is very difficult, protective measures should be taken at an early stage. The things that can be done are as follows:
Prevent your baby’s habit of sleeping with a bottle in their mouth at night. Try to put them to sleep after feeding. Do not add sweeteners such as sugar, honey, or molasses to the milk in the bottle. Be sure to give the baby water to drink after feeding. With the eruption of the first teeth, clean them by wiping them with a clean, damp gauze after night and morning feedings. Are dental caries contagious?
One of the latest issues on which consensus has been reached in dentistry is that dental caries is a contagious disease. Many bacteria are responsible for dental caries, and the most important bacteria among these are the ‘Streptococcus Mutans’ group of bacteria.
Babies are not born with streptococcal bacteria in their mouths. The first route of transmission of bacteria to babies is usually through the mother. Streptococci, which are naturally found in the mother’s saliva, can first be transmitted by kissing, and later by the mother tasting the food with the baby’s spoon or checking the temperature of the milk or formula in the bottle.
So, what should mothers do to protect their babies from possible bacterial transfer in this case? The most important and first thing to do is for the mother to have excellent oral and dental care. This means brushing teeth and using dental floss regularly every day. The second step is regular dental check-ups to eliminate the risk of decayed teeth and gum disease in the mother’s mouth. It would not be entirely correct to limit this problem to the mother. All precautions should also be taken for other people who have close contact with the baby.
Other points to consider are:
Never use the same toothbrush as your child. If possible, use a separate spoon for your child at meals, and check the food with another spoon. Do not cool your baby’s food in your mouth. Do not put your mouth on your baby’s bottle or pacifier. (Some mothers do this for cleaning purposes.) Make sure that people who come into contact with your child other than you do not have cold sores, gum disease, or oral and dental health problems. When you have taken all these precautions, kiss them a lot…
What are the teething symptoms in babies?
One or two days before teething, fussiness, loss of appetite, itching in the gums, and an increase in saliva may occur. The gum is swollen in the area where the tooth will erupt. All these complaints disappear with the eruption of the teeth. There is no medication to relieve these complaints. However, ointments sold in pharmacies to be applied before meals can be used.
In the past, every complaint of a child who reached the age of teething was attributed to teething. Although teething has some effects on general health, diseases such as seizures, diarrhea, and bronchitis are no longer attributed to teething. To hold teething responsible for the deterioration in the child’s general condition, all other causes must be investigated.
What is the eruption schedule of primary and permanent teeth?
Generally, the first teeth in babies begin to erupt at 6 months of age. The eruption of primary teeth is completed between 24 and 30 months. A child with complete primary teeth has a total of 20 teeth, 10 in each jaw. Sometimes, babies can be born with teeth or erupt teeth immediately after birth. These teeth are usually wobbly teeth and need to be extracted with the thought that the baby may swallow them or they may get into the windpipe. Another problem they create is irritation of the mother’s nipple during feeding. In such a case, the intervention of a dentist is necessary.
Delays in teething can also occur due to some factors related to the baby. This condition is considered normal up to 1 year of age. However, if the baby is 1 year old and still has no teeth in their mouth, they should be taken to a dentist to investigate the cause.
At the age of 6, permanent teeth, which we call ‘6-year molars’, begin to erupt behind the primary molars. These teeth are a total of four, two on each side in the upper and lower jaws. Since they are usually mistaken for primary teeth, they are extracted without treatment when they decay. However, the extraction of these teeth, which are very important for the dental system, causes crowding in the teeth that is very difficult to treat. To protect these first permanent teeth, which remain in the mouth for life and are the center of chewing, applications called ‘fissure sealants’ that protect the tooth against decay should be made.
Primary teeth protect the space where permanent teeth will erupt. If primary teeth have to be extracted early, ‘space maintainers’ should be used to protect this area. They can be prepared as removable or fixed (bonded), depending on the condition of the remaining teeth and the child’s compliance.
Between the ages of 7-11, primary teeth become loose, and the permanent teeth coming from underneath replace them.
At the age of 12, the second permanent molars erupt behind the 6-year molars. Like the 6-year molars, these are also teeth that do not erupt in place of a primary tooth.
What is the cause of tooth discoloration?
Just like in children or adults, discolorations can be seen in newly erupted primary teeth in babies. The most important reason for this is ‘bacterial plaque’. If a yellowish or orange-colored appearance begins to form on your baby’s teeth, this is a sign that bacterial plaque has adhered to your baby’s teeth.
Bacterial plaque is a complex formation that is quite sticky and contains bacterial colonies, as its name suggests. It forms within 24 hours in cases where tooth brushing is neglected in babies and children and can mature rapidly, leaving permanent damage on the teeth.
Bacterial plaque is the primary cause of dental caries and gum problems in babies and children. As soon as you see such an appearance in your baby’s mouth, clean their teeth with a soft-bristled brush produced for babies. If you have difficulty removing bacterial plaque from the teeth, then try to remove the plaque by using very little (half the size of a chickpea) children’s toothpaste. If the stains on the teeth do not go away despite all these efforts, be sure to consult your pedodontist/pediatric dentist.
Remember that the first appearance of dental caries in babies also exhibits a white/yellowish character.
If you observe black discolorations on your baby’s teeth, do not immediately consider these black spots as dental caries. Usually, iron preparations or multivitamin drops that you use for your baby can leave temporary black spots on the teeth. You can ensure that these spots do not form at all or form very little with regular tooth brushing.
In the meantime, let’s clarify the common complaint of many parents that “our baby’s teeth turned yellow from the antibiotics they used.” Today, antibiotics used for babies/children are offered to people/physicians after many research and development stages. Currently, no antibiotic that your pediatrician will prescribe will stain the teeth. However, if you do not brush your baby’s teeth during their illness, the antibiotic, like the food they eat/drink, will adhere to their teeth as bacterial plaque and can cause temporary (until the teeth are brushed) discolorations.
Another discoloration seen in primary teeth is due to trauma. Your baby will definitely fall down a bit out of curiosity and a bit due to accidents, especially when they first start walking. Sometimes these falls can be simple enough not to make them cry, while other times they can cause serious problems. If they fall on their teeth, the teeth may lose their vitality depending on the severity of the fall, and the color of the teeth may turn a dull grayish color. In such cases, be sure to consult your pediatric dentist immediately.
All the discolorations mentioned so far are temporary discolorations that can be removed by cleaning the teeth. In addition to these, excessive fluoride consumption in primary and permanent teeth and infections due to high fever during pregnancy or in the first months after birth can also cause tooth discoloration. You can get detailed information about such cases from your pedodontist.
What should be done to overcome the fear of dentists in children?
If you explain to your child that there is nothing to fear about dental treatment, you can easily take them to the dentist. However, parents usually turn going to the dentist into a source of fear. Therefore:
Taking the child to the dentist should not be a punishment. On the contrary, an environment should be created where they will enjoy going. Another point to pay attention to is not to create an association between going to the dentist and the pain the child will experience. Misleading the child by saying “Your tooth won’t hurt at all” or “The doctor won’t give you a shot” makes future treatments more difficult. A good dialogue between the dentist and the child is a helpful factor in overcoming the child’s fear. For this, the child should be allowed to answer the questions asked by the dentist themselves. Should primary teeth be treated?
Primary teeth contain more organic matter than permanent teeth, so they are prone to easy and rapid decay. Primary teeth should be treated just like permanent teeth. Moreover, extracting these teeth with the thought that they will be replaced causes many problems. We can explain the importance of primary teeth as follows:
Primary teeth are important for nutrition. Children with decayed teeth cannot eat properly because their teeth hurt. Similarly, children whose teeth have been extracted cannot grow and develop properly because they cannot eat. Primary teeth are also necessary for jaw development. In children whose teeth are extracted due to decay or gum problems, the jaws collapse, and they take on an aged appearance. Teeth are necessary for speaking. Especially during the period when speech is being learned, the absence of front primary teeth will cause the letters f, v, s, z, t to be mispronounced for life by becoming a habit. Every child loves to smile. Healthy teeth are needed for a beautiful smile. Looking good is the most natural desire of every person, young and old. Children with decayed or missing teeth feel psychologically uncomfortable, thinking they look ugly. Another function of primary teeth is to protect the space of the permanent teeth that will come from underneath. If a primary tooth is extracted before its time, the adjacent teeth shift towards this gap. There is no space left for the permanent tooth that will come from underneath. This tooth compresses the others, resulting in crowding. How should oral care be in children?
As soon as the first teeth appear in the mouth, cleaning should begin. It is necessary to clean the teeth by wiping them with a clean gauze or muslin cloth after breakfast and before going to bed at night. Toothbrush use can be started after the baby’s back teeth have erupted. The first brushing attempts can be quite difficult, even unsuccessful, but over time, this will become a pleasant habit for your baby. Especially when primary teeth are just beginning to erupt, regular brushing will have a massage effect on the gums, causing your baby to relax and reducing teething pain.
In preschool children, what is important is to instill the habit of brushing teeth. An effective brushing process of only three minutes before breakfast and before going to bed at night is sufficient. However, children often brush the visible or easily accessible surfaces of their teeth while brushing. Whereas, microbes accumulate more easily on the interdental surfaces or chewing surfaces of the teeth. For this reason, parental supervision is essential after brushing.
Toothbrushes suitable for the child’s mouth size, with soft and nylon bristles, should be used. Hard brushes are not suitable for use as they will erode the teeth. Brushes must be changed on average after 6 months.
Another frequently asked question by families is about the concerns regarding the use of toothpaste during tooth brushing. Babies and children usually love the taste of toothpaste and swallow it while brushing. For this reason, it would be a more correct approach not to use toothpaste when brushing the teeth of children younger than 2.5-3 years old. However, it would not be correct to make a generalization on this issue for all children. Therefore, the most correct thing to do is to decide whether or not to use toothpaste while brushing your baby’s teeth by consulting your pedodontist. Remember that fluoridated toothpaste that children can swallow in excess can create problems for both their teeth and their general body health.
How to instill the habit of brushing teeth in children?
Brush your own teeth with a separate toothbrush while they are brushing their teeth. Get them a few toothbrushes. Let these brushes be of different colors and have different comic book characters on them. Have them choose a different brush each time. This choice will increase their desire and motivation to brush their teeth. First, let them brush their own teeth, then you brush theirs, and they brush yours. Be sure to create a tooth brushing chart at home and make a mark on the chart after each brushing. Place an hourglass in the bathroom and keep time by turning the hourglass upside down each time you brush. Approximately 2 minutes of tooth brushing will be sufficient. Remember that your baby or child has no information about tooth decay. Feed them sticky sugar, chocolate, or biscuits and show them in the mirror how they stick to their teeth. Then have them brush their teeth and show them in the mirror how beautiful, clean, and white their teeth are. It should be remembered that regular tooth brushing will play a major role in preventing future dental problems in your child.
Does the child’s feeding style affect their dental health?
Healthy eating means taking all the nutrients necessary for the child’s growth and development in a balanced way. That is, they need to regularly consume main food groups such as vegetables, fruits, milk, meat, fish, and eggs. This affects their general physical development as well as plays a very important role in their tooth/gum development. For example, a child with a carbohydrate-rich diet is at risk for the formation of dental caries. Therefore:
Try to reduce the consumption of foods containing sugar and starch by being more selective about these foods while shopping. Allow them to consume these foods only during main meals. Regulate your child’s feeding times and ensure that they are fed with foods of high nutritional value at each meal. Do not allow your baby to sleep with a bottle in their mouth during sleep. If your child likes to chew gum, make sure they chew sugar-free gum. What should be done in case of emergencies?
We can group the possible emergency dental problems that may occur in children into two categories:
Injuries resulting from impact/falls Toothache Injuries resulting from impact/falls
As most of us know, children learn to walk by falling and getting up. While these falls can usually be overcome without damage, sometimes unwanted situations can be encountered. If the child is in the primary dentition period (0-6 years), sometimes the front primary teeth can become completely or partially embedded in the jawbone due to impact and falls. Usually, these teeth re-erupt from their old places within 3-9 months. However, since there is a possibility of damage to the permanent teeth under these teeth during the impact, as well as fractures in the jaw, a pedodontist/dentist should be consulted as soon as possible.
During the time until going to the dentist, rinsing the mouth with lukewarm water and applying a cold compress to the injured area will prevent possible swelling. Permanent teeth that come out of their place as a result of injury have a very high chance of healing when they are put back in place. In cases where the tooth comes out of its socket completely, the tooth should be held without touching the root end, placed in physiological saline, milk, or water if these are not available, and a dentist should be visited without delay. It should be remembered that early interventions prevent serious problems that may occur in the future.
Toothache
One of the most common situations is sudden toothaches that usually occur at night. In such cases, first rinse the child’s mouth with water to make them comfortable. Then clean their teeth with a toothbrush and dental floss. Sometimes, simply by these two methods, your child’s toothache can be easily relieved by removing food debris trapped between the teeth. If the pain does not go away despite these two procedures, it means that a painful condition called ‘pulpitis pain’ has started in the teeth. Apply cold water or ice to the area where the aching tooth is to relieve the existing pain. Cold application will cause the pain to decrease. Absolutely do not apply HOT WATER or ASPIRIN to the aching tooth. If the pain does not subside despite all these procedures, using a pain reliever syrup or tablet that your dentist will recommend will help reduce the pain.
In all the emergency situations mentioned above, the first thing you should do is to contact your pedodontist/dentist immediately. For this reason, be sure to save your doctor’s phone numbers in an easily accessible place to be used in such emergencies.